The Importance of Incorporating Advocacy in Our Daily Professional Practice
As residents, fellows, and attending physicians, our involvement in advocacy should begin early in our careers. I was fortunate that my exposure to advocacy started early during my training in medical school and continued during my residency. I was surrounded by mentors who showed me the importance of our role as child and adolescent psychiatrist in advocacy and encouraged me to be a voice of our patients and our profession. Organizations such as the AACAP provide support and development for members to become effective advocates and leaders in our profession. In 2005, I was selected as an APA/AACAP Jeanne Spurlock, M.D. Congressional Fellow in Washington, D.C. I worked with US Senator Gordon H. Smith, from Oregon. Taking a leadership role with Senator Smith, on behalf of the Psychiatric community, was a tremendous privilege. The dynamic, fast-paced environment of Capitol Hill can easily faze an "outsider" like me, but I took this as an opportunity to communicate the message of our unheard patients. I reached out to the AACAP Government Affairs for guidance on adapting and reacting to these obstacles and barriers.

Early on during the fellowship, I took a leadership role in bringing together some of the most influential HIV / AIDS organizations and moderating a roundtable discussion about HIV/AIDS issues. The result was the re-introduction of Senator Smith's Early Treatment for HIV Act (ETHA). ETHA provides states the option to extend Medicaid coverage to low-income, HIV-positive Americans before they develop full-blown AIDS. With the partnership of Senator Smith and the HIV / AIDS organizations, I championed a "Dear Colleague" letter addressed to other influential US Senators soliciting more funding for the AIDS Drug Assistance Programs (ADAP), which provides FDA approved HIV-related prescription drugs to uninsured and underinsured individuals living with HIV/AIDS. With the re-authorization of the Ryan White Care Act that year, the Special Committee on Aging enthusiastically supported my initiative on a hearing discussing HIV. My goal was to increase the public's awareness of HIV in children and adolescents and the challenges that their family face.

My exposure and experience here put things in perspective. I learned the appropriate skills when meeting with legislators and lobbying on Capitol Hill. As a Congressional fellow, I appreciate how important it is for our profession to be involved with the United States legislation. As an advocate for child mental health care, this experience has only strengthened my drive to affect change through legislation and to support initiatives that improve the mental health of the constituents. As I advance in the honorable profession of Psychiatry, I will always emphasize the importance of community service and patient advocacy, especially for children. This has been a rare exposure to the insider's view of our United States government. It is a unique and once-in-a-lifetime opportunity. As advocates in our profession, we can become the voice of our patients. We are rewarded by influencing and improving mental health care policy.

Jose Vito, M.D.
Jose Vito, M.D. is an Early Career Psychiatrist at Albert Einstein College of Medicine and is also the current president of the New York Council on Child and Adolescent Psychiatry. He has been attending the AACAP Advocacy Day in Washington, D.C. every year since 2005.

Every physician is involved advocacy. When advocating for a patient's access to medication through a pre-authorization process or when advocating for accommodations at work or school for a patient - this is advocacy. The more difficult question to answer is how any of us can get more involved than direct patient care. While there is no 'one correct path', let me describe the different ways I am active in advocacy. I am the Executive Medical Director and Chief of Staff of Vanderbilt Psychiatric Hospital. In this role, I routinely get to advocate for the creation of new services, improvement of existing services, or management of staff such that it impacts patients and the community in a beneficial manner. Being co-chair of the Healthcare Access and Economics Committee at the American Academy of Child and Adolescent Psychiatry (AACAP) allows me to advocate for both my patients and my profession, as this committee considers access to services as well as coding and reimbursement. Past experiences as a Congressional Fellow in the US Senate as well as current involvement through Advocacy Days with various medical organizations has allowed for opportunities to draft legislation, to provide testimony at legislative hearings, to meet with my elected officials, and to advocate for or against specific bills both locally and nationally. While working in the US Senate, I was fortunate enough to draft legislation (which passed both houses of Congress and was signed into law) related to suicide prevention and improving college mental health services. Additionally, being the Consulting Editor of the Child and Adolescent Psychiatric Clinics of North America allows me to advocate for evidence-based care as well as the translation of cutting-edge research to practical clinical applications. Lastly, as an academician and as a clinician educator, there are daily opportunities to advocate for improved education, teaching, and supervision of medical students, residents, and fellows. These are just some of the many wonderful ways any of us can get involved and can really make a difference.